Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan.
Division of Transfusion Medicine and Cell Therapy, Tokushima University Hospital, Japan.
Intern Med. 2021 Jun 1;60(11):1753-1757. doi: 10.2169/internalmedicine.4916-20. Epub 2021 Jan 15.
A 33-year-old man was admitted to our hospital for fever and abdominal pain. A blood analysis revealed pancytopenia and increased serum pancreatic enzymes with disseminated intravascular coagulation. A detailed examination revealed acute pancreatitis, with diffuse swelling of the pancreas and diffuse beaded dilatation of the main pancreatic duct, which mimicked autoimmune pancreatitis complicated by acute myeloid leukemia. Systemic cytotoxic chemotherapy led to the remission of leukemia and pancreatitis. We hypothesized that the etiology of acute pancreatitis was invasion of leukemia cells. Acute pancreatitis is rare as a symptom of leukemia; however, we should consider the possibility of leukemia during the differential diagnosis of acute pancreatitis.
一位 33 岁男性因发热和腹痛入院。血液分析显示全血细胞减少和血清胰腺酶升高,伴有弥漫性血管内凝血。详细检查发现为急性胰腺炎,胰腺弥漫性肿胀,主胰管弥漫性串珠状扩张,类似于伴有急性髓系白血病的自身免疫性胰腺炎。全身细胞毒性化疗导致白血病和胰腺炎缓解。我们推测急性胰腺炎的病因是白血病细胞浸润。急性胰腺炎作为白血病的症状较为罕见;然而,在急性胰腺炎的鉴别诊断中,应考虑白血病的可能性。